Suboxone vs Naloxone
Suboxone and naloxone are two very different medications. Naloxone is a rescue medication to prevent overdose, while Suboxone helps people find recovery from opiate addiction. Here’s a look at these two medications.
What is the difference between Suboxone and naloxone?
Suboxone is a medication that combines buprenorphine with naloxone to help people find long-term recovery from opioid use disorder. When taken as directed, the naloxone in it has little to no effect, but does protect against a high or overdose if Suboxone is diverted or taken inappropriately.
Naloxone (brand name Narcan), when used as a stand-alone medication, is a rescue medicine that rapidly reverses an opioid overdose.
Suboxone (buprenorphine/naloxone) FAQs
Suboxone is the brand name for an FDA-approved medication (buprenorphine/naloxone) used to treat opioid addiction. This medication is endorsed by the Substance Abuse and Mental Health Service Administration as the preferred method of treatment for opioid addiction treatment.
Suboxone helps to alleviate the brain’s dependence on opioids, like heroin, fentanyl, and other prescription pain relievers, while also reducing withdrawal symptoms and cravings. Suboxone is part of a group of interventions called medication-assisted treatment used to treat opioid use disorder.
How does Suboxone work?
Suboxone is a medication used to sustain recovery from opioid use disorder. It is called a partial opioid agonist, meaning it works in a similar way to opioids by binding to opioid receptors in the brain which causes limited pleasurable effects to stop withdrawal symptoms. However, it won’t provide the “high” associated with opioids like heroin. Suboxone also contains naloxone (known by the brand name Narcan), which is an opioid antagonist meaning it blocks opioid receptors, preventing misuse.
Bottom line, Suboxone:
- Helps alleviate withdrawal symptoms
- Reduces cravings for opioids
- Prevents misuse of Suboxone and/or other opioids
- Decreases the risk of relapse
Like other medication-assisted treatments, Suboxone is often prescribed alongside behavioral therapy, which has been found to be most effective in the treatment of opioid addiction. You can read more about the science of Suboxone in our Health Guides.
Do I have to stop using opioids to take Suboxone?
Yes. According to the American Society of Addiction Medicine, you will need to prepare for your first dose of medication-assisted treatment containing buprenorphine. This means stopping using opioids for a specified amount of time before you take Suboxone in order to prevent unpleasant side effects. That time period depends on whether the opioid you have been taking is a short-acting or long-acting opioid. Generally speaking, short-acting opioids like Percocet, heroin, and Vicodin should be ceased 12-24 hours before your first dose. Longer-acting opioids, like morphine, methadone, and Oxycontin are generally discontinued 36-48 hours before your first dose of Suboxone.
The key is checking in with an experienced physician licensed to prescribe this medication, who can advise you of the appropriate time frame based on your unique medical history.
What are the side effects of Suboxone?
Like with any medication, some people experience side effects when taking Suboxone. These may subside over time. Common side effects include:
- numbness in the mouth
- mouth redness
- numbness or tingling
- sleep problems
- stomach pain
- difficulty concentrating
- mouth pain
What form does Suboxone come in?
Suboxone is a sublingual film. It is important to allow the medication to fully dissolve under the tongue or against the cheek (not chewing or swallowing) in order to receive the full dosage, as buprenorphine is not absorbed well in the stomach or intestines.
Why is there naloxone in Suboxone?
You may have heard of naloxone under the brand name Narcan. Narcan and other naloxone-only formulations are life-saving medications that can reverse an opioid overdose almost instantly. This means that if someone has too much of an opiate in their system, naloxone will bind more strongly to those receptors, knocking them free and reversing a potentially fatal overdose.
As mentioned above, Suboxone is taken sublingually (placed under the tongue and allowed to dissolve). This is because buprenorphine is absorbed really well under the tongue. Naloxone, however, does not absorb well sublingually. When you take Suboxone as prescribed, the naloxone is essentially doing nothing. It is only is Suboxone is taken inappropriately that naloxone will kick in, blocking an illicit high or overdose. This makes Suboxone less likely to be diverted or misused.
Naloxone (Narcan) FAQs
Naloxone (brand name Narcan) is an FDA-approved medication designed to rapidly reverse an opioid overdose. It works by binding to opioid receptors in the brain and reversing and blocking the effects of opioids.
Naloxone is an active ingredient within Suboxone. It is not present in a high enough dose to have the effects of Narcan, but it can limit the effects of other opioids when taken in the Suboxone formulation. It reduces the risk of overdose and protects against feeling a high if Suboxone is misused or diverted.
How does naloxone work?
Naloxone is a full opioid antagonist. It dislodges opioid molecules from the brain’s receptors and blocks them from binding again. This effect can quickly restore a person’s breathing to normal if that person’s breathing has slowed down or stopped because of an opioid overdose. Naloxone WILL NOT improve breathing in people who have overdosed on other substances (such as alcohol) or for other reasons (such as asthma).
Can I use naloxone to treat opioid use disorder?
No. Naloxone is a life-saving antidote in opioid overdose emergencies. But naloxone cannot treat the underlying problem that caused the overdose: addiction to opioids. A combination of counseling and medications such as methadone, Suboxone, or naltrexone is your best bet for recovery.
Do I still have to call 9-1-1 after giving naloxone?
Yes! Think of naloxone like CPR for a heart attack—both are vital for keeping a person alive by buying time for emergency medical services to arrive. If you administer naloxone, you must also call 9-1-1. Naloxone’s effects last for 30-90 minutes, whereas the effects of certain opioids can four or more hours. So a person could actually re-overdose after naloxone wears off because the opioid is still in their system. Don’t risk it; call 9-1-1.
What are the side effects of naloxone?
The use of naloxone causes opioid withdrawal symptoms, including nervousness, irritability, body aches, feelings of restlessness, diarrhea, stomach pain or nausea, fever, chills, and sneezing or runny nose. These are not so much side effects of naloxone as they are the results of the original opioid use, but they can be uncomfortable.
Where can I get Suboxone or naloxone?
Workit Health offers Suboxone treatment in many states (see our map below). While Workit’s telemedicine Suboxone treatment is 100% virtual in most states, Ohio may require a single in-person appointment to receive Suboxone. If you aren’t in our area, learn other strategies for finding a Suboxone Clinic near you.
To find Suboxone treatment in your area, the NAABT has a directory called Treatment Match which will connect you with local providers. And the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a Buprenorphine Practitioner Locator.
You can locate naloxone at most pharmacies without a prescription, through insurance, and from some community organizations. There are local drives in some areas that provide naloxone for free, to help reduce overdose deaths in the area. Its availability varies from state to state. You can find out how to get Narcan via the Narcan website.
Medication-assisted treatment available in many states
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Has my opioid use become a problem?
Take our opioid self-assessment to check on your use. This tool should not be used as a replacement for a clinical diagnosis.
Opioid Use Self-Assessment Quiz
Take our opioid self-assessment to check on your use and find out if Workit Health is right for you. This screening tool is a self-evaluation adapted from the DSM screening tool, and is designed as a self-assessment of opioid use.